Peripartum thromboprophylaxis for homozygous and heterozygous FVL mutation carriers yields similar pregnancy outcome (original) (raw)
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The Putative Role of Factor V Leiden and Prothrombin Mutations in Pregnancy Complications
Journal of paramedical sciences, 2019
Context: Thrombophilia is an inherited or acquired predisposition in developing thrombosis. The two common thrombophilia polymorphisms are factor V Leiden (FVL) and factor II/ prothrombin G20210A (PT) gene mutations which can contribute to negative pregnancy outcomes such as miscarriage, in-vitro fertilization (IVF) failure, preeclampsia, intrauterine growth restriction (IUGR), placental abruption, stillbirth, and pregnancy-associated venous thromboembolism. This review study sought to describe the effects of FVL and PT mutations on pregnancy complications. Evidence Acquisition: In this review study, a comprehensive search was performed on Iranian and international databases including MEDLINE, PubMed, Scopus, Web of Sciences, Proquest and Google Scholar for articles published during 1996-2018. Out of 220 reviewed articles, 80 papers were ultimately selected. Results: According to these 80 selected papers, the possible relations of PT and FVL with recurrent pregnancy loss (RPL) have ...
British Journal of Haematology, 2003
The risk of venous thromboembolism (VTE) in the absence of prophylaxis was evaluated in a retrospective study of 47 women (84 pregnancies) with combined thrombophilia [heterozygous factor V Leiden (FVL) plus prothrombin (FII) 20210A mutation (group I)] and in 82 women (193 pregnancies) with the FII alone (group II). VTE was more frequent in group I than in group II [17AE8% versus 6AE2%, P ¼ 0AE003, relative risk (RR) 2AE9, 95% confidence interval (CI) 1AE4-5AE9], ante partum (7AE1% and 2AE1%) and post partum (11AE5% and 4AE2%). The risk was higher in index cases than in family members (RR 2AE5, 95% CI 1AE2-5AE2 and RR 2AE1, 95% CI 0AE2-22AE3 respectively) Even women who had no history of VTE before pregnancy had an increased risk (RR 2AE2, 95% CI 1AE0-4AE8). Our results suggest that, during ante partum, prophylaxis is indicated in women with combined thrombophilia and with a VTE before pregnancy. In those without VTE before pregnancy, prophylaxis might be decided for each individual case, taking into consideration all risk factors. In women with the FII mutation alone, the low risk may not justify prophylaxis in the absence of previous VTE. In post partum, prophylaxis is indicated in all cases.
Factor V Leiden G1691A and Prothrombin Gene G20210A Mutations on Pregnancy Outcome
Cureus, 2021
Factor V Leiden (FVL) G1619A mutation and prothrombin gene (PTG) G20210A are the most common inherited thrombophilias. They have been associated with various obstetric complications such as venous thromboembolism, recurrent pregnancy loss, preeclampsia, abruptio placentae, and small for gestational age fetus. The prevalence of these two mutations is 3-15% in Caucasians and is assumed to be far less common in other ethnic populations. However, there have been several controversies regarding advising routine screening of these thrombophilias because of a widely variable strength of association between different ethnic groups, as well as contradictory conclusions by different studies in regards to the association. In this study, the literature was analyzed thoroughly for the effect of FVL G1619A and PTG G20210A mutations on various obstetric outcomes. A review of multiple case-control and prospective studies suggests that despite the availability of robust data on this subject the resu...
Thrombosis Research, 2007
Introduction: Hereditary and acquired risk factors increase the risk for thrombosis among pregnant women. Few risk estimates are, however, well established. The aim of the present study was to assess risk for pregnancy-associated venous thrombosis of factor V Leiden (FVL), FII G20210A, FV A4070G, MTHFR C677T, TFPI C536T, PROC T38853G, FXIII V34L, blood group, age, and body mass index (BMI), and their interactions and public health impact.
Factor V Leiden mutation and its impact on pregnancy complications
Acta medica (Hradec Králové) / Universitas Carolina, Facultas Medica Hradec Králové, 2011
The aim of this prospective study was to find the association between the factor V Leiden mutation and adverse pregnancy outcomes. This study is an analysis of a prospective observational study of the frequency of placenta-mediated complications of factor V Leiden mutation carriers. We compared pregnancy outcomes of 11 women with a heterozygous form of the factor V Leiden mutation with 41 women of a control group. All pregnancies ended with delivery of a living infant. None of the 52 pregnancies were complicated by venous thromboembolism. There were a few significant differences regarding placenta-mediated complications. The gestational age at delivery showed small significant differences. There was a significant difference in the birth weight deviation in percentage between FVL carriers and controls. The incidence of blood loss exceeding 1000 ml was higher in the control group. Carriership of the factor V Leiden mutation did not affect the incidence of preeclampsia. Adverse pregnan...
Factor V Leiden, pregnancy complications and adverse outcomes
QJM, 2006
Background: The factor V Leiden (FVL) mutation is the most common cause of inherited thrombophilia in Caucasian populations, and women with this variant allele are at increased risk for pregnancy complications. Aim: To examine whether the FVL allele is associated with pregnancy complications and adverse outcomes in a population-based study, and to identify potential factors that interact with the FVL genotype. Design: Retrospective cohort study in a geographically-defined area. Methods: Polymorphisms of factor V 1691G!A, methylenetetrahydrofolate reductase (MTHFR) 677C ! T and 1298A ! C and plasma levels of total homocysteine, folate and vitamin B 12 were determined in blood samples collected in 1992-1993 from 5874 women aged 40-42 years, and linked with 14 474 pregnancies in the same women, recorded in the Medical Birth Registry of Norway, 1967Norway, -1996 Results: The allelic frequency of FVL was 3.7% (6.9% heterozygotes, 0.3% homozygotes). Maternal FVL mutation was associated with significantly higher risks of pre-eclampsia (OR 1.63, 95%CI 1.15-2.30), pre-eclampsia at <37 weeks (OR 2.76, 1.34-5.70), low birth weight (OR 1.34, 95%CI 1.03-1.74) and stillbirth (OR 2.20,. The presence of a variant allele for the 677C ! T MTHFR polymorphism strengthened the association between FVL and stillbirth (OR 3.34, 95%CI 1.95-5.73) (p interaction ¼ 0.034). Discussion: FVL mutation is a significant risk factor for pregnancy complications and adverse outcomes, and MTHFR 677CT/TT genotype can further enhance the risk of stillbirth.
Biomedical Research and Therapy
Background: Thrombophilia is an inherited or acquired predisposition for development of thrombosis. One of the common thrombophilia polymorphisms is Factor V Leiden (FVL) mutation, which may contribute to negative pregnancy outcomes. This systematic review study seeks to describe the potential effects of factor V Leiden mutation on adverse pregnancy outcomes. Methods: Pubmed, Embase, ISI Web of Sciences, Scopus, ScienceDirect, Proquest and Google Scholar, for articles published during 1996-2017. Articles were evaluated by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for standard reporting. As well, the quality of studies was assessed by the Newcastle-Ottawa Scale (NOS). Results: A total of 14 studies were eligible based on the inclusion criteria. The papers were scored by the STROBE checklist. The range of STROBE score was 15-20. Only 37.5% of the studies confirmed the relationship between fetal loss and FVL. The effect of FVL mutation ...
The effect of factor V Leiden carriage on maternal and fetal health
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2002
Factor V Leiden is a common genetic mutation that predisposes its carriers to venous thromboembolism. When combined with the hypercoagulable state that is characteristic of pregnancy, there is an increased risk of severe and recurrent pregnancy complications. Factor V Leiden is the most common cause of primary and recurrent venous thromboembolism in pregnancy. Factor V Leiden carriage has consistently been shown to increase the risk of early onset gestational hypertension and HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) in pregnancy. Maternal carriage of factor V Leiden is also associated with severe placental abruption and fetal growth disturbances. Although it is unclear whether factor V Leiden causes an increased risk of first trimester miscarriage, it is associated with stillbirth and placental infarction. Patients with venous thromboembolism or severe pregnancy complications should be tested for factor V Leiden and other inherited and acquired thrombophilia...